Surinamese Children Research Articles

The utility of the child development review in Suriname: Validating a neurodevelopmental screener for use in a low- to middle- income Country

BackgroundAccess to efficient, culturally relevant, and validated measures of neurodevelopment in Low- and Middle-Income Countries (LMICs) remains a critical need. This study describes the validation and reliability of the Child Development Review (CDR), a parent report neurodevelopmental screening tool, for use in a cohort of Surinamese children aged 2–4 years. SubjectsComplete data from 355 Surinamese children through the Caribbean Consortium for Research in Environmental and Occupational Health were utilized for validation. Convergent validity was assessed using a subset of 31 children with concurrently administered CDRs and Bayley Scales of Infant and Child Development Third Edition (BSID-III). MethodsCronbach's alpha was used to assess subscale reliability. Cluster analyses were used to assess internal factor structure. Measures of convergent validity used Cohen's Kappa statistic and partial correlations between comparative CDR and BSID-III subscales. ResultsCronbach's Alpha values were acceptable for all CDR subscales (range 0.63 - 0.79). CDR subscale responses clustered into two distinct groups, representing milestones that were or were not achieved. Patterns of change indicate increased milestone achievement with increased age. Partial correlations indicated that the social, fine motor, and language subscales of the CDR and BSID-III subscales were significantly correlated. However, Cohen's Kappa was only significant for the gross motor CDR and BSID-III subscales. ConclusionsThe CDR has acceptable reliability, internal validity, and convergent validity. Use of the CDR should be considered as a screening tool for neurodevelopment in Suriname and may provide an efficient initial assessment of developmental delay in LMIC.

Viral causes of severe acute respiratory infection in hospitalized children and association with outcomes: A two-year prospective surveillance study in Suriname.

BackgroundViruses are the most frequent cause of severe acute respiratory infection (SARI) in children. It is currently unknown whether presence of a virus, the number of viruses, or type of virus, are associated with clinical outcomes of pediatric SARI in developing countries.MethodsBetween 2012 and 2014 nasopharyngeal swabs and demographic and clinical variables were prospectively collected for surveillance of viral causes of SARI in Surinamese children within 48 hours after hospitalization. These swabs were tested for 18 respiratory viruses using a multiplex polymerase chain reaction (PCR) panel to identify the specific viral causes of SARI, unknown to the treating physicians. In post hoc analyses we evaluated if the PCR results, and demographic and clinical characteristics, were associated with course of disease, duration of respiratory support, and length of stay (LOS).ResultsOf a total of 316 analyzed children, 290 (92%) had one or more viruses. Rhinovirus/enterovirus (43%) and respiratory syncytial virus (34%) were most prevalent. Course of disease was mild in 234 (74%), moderate in 68 (22%), and severe in 14 (4%) children. Neither presence of a single virus, multiple viruses, or the type of virus, were different between groups. Prematurity and lower weight-for-age-z-score were independent predictors of a severe course of disease, longer duration of respiratory support, and longer LOS.ConclusionsViruses are common causes of pediatric SARI in Suriname, yet not necessarily associated with clinical outcomes. In developing countries, demographic and clinical variables can help to identify children at-risk for worse outcome, while PCR testing may be reserved to identify specific viruses, such as influenza, in specific patient groups or during outbreaks.

Empowering Dutch and Surinamese children to prevent viral infections: implications from an international education module.

Viral infections have a large share in human morbidity and mortality. Next to vaccinations and hygiene measures, health education plays a role in preventing infections. Social scientists argue that empowerment should be included in health education, as increasing knowledge is insufficient to achieve sustainable behaviour change. Within the international education module 'Viruskenner', primary school students learn how to prevent virus infections by identifying health risks and developing interventions. This qualitative formative study explored to what extent Viruskenner creates conditions in which empowerment processes can arise and take place in the Netherlands and Suriname. Indicators of empowerment, as defined in the literature and placed in the attitude, social influence, and self-efficacy model, were assessed during semi-structured interviews (n = 24) with students, parents, teachers and facilitators. We conclude that Viruskenner is successful in creating conditions for empowerment processes to arise and take place, specifically in attitude and self-efficacy. According to interviewees, the module raised students' motivation, skills and confidence to take action to improve health behaviour. Educators played a stimulating role in the participatory setting in both countries, while content relevance and community involvement differed between the Netherlands and Suriname. These outcomes could improve this module and possibly other health education programmes.

Serum Levels of Markers of Endothelial Activation Are Not Associated with a Positive Blood Culture in Surinamese Children with Suspected Severe Infection.

Systemic serum levels of markers of endothelial activation are associated with infection. We hypothesize that levels of markers of endothelial activation are associated with the presence of a positive blood culture as a manifestation of a systemic infection in children with a suspected severe infection in Suriname. In this prospective observational cohort study, children between 1 month and 18 years of age suspected of severe infection as assessed by the threating physician, and in whom laboratory testing and blood culturing was performed before start of intravenous antibiotic treatment, were recruited at the emergency department of the Academic Hospital Paramaribo, Suriname. Serum was collected at blood culturing and after 48-72 h of admission. Serum was stored for measurement of levels of Angiopoietin (Ang)-1, Ang-2, soluble (s)P-selectin, sE-selectin, vascular cell adhesion molecule-1, intercellular adhesion molecule-1 and platelet and endothelial cell adhesion molecule-1. Fifty-one children were included of whom 10 had a positive blood culture. Baseline characteristics were similar between children with and without a positive blood culture. No significant differences in serum levels of the Angiopoietins or soluble cellular adhesion molecules between groups were observed at start of antibiotic treatment nor after 48-72 h. The data from this study indicate that in children with severe infection, serum levels of markers of endothelial cell activation are not associated with a positive blood culture. Thus, having a positive bacterial blood culture may not be the only factor driving endothelial activation in this patient population.

Economic Assimilation of the "Third Generation": An Intergenerational Mobility Perspective on Immigration and Integration

This paper examines ethnic disparities in intergenerational economic mobility for the children of second-generation migrants. Using rich register data for adult children aged 20 to 30, we provide empirical evidence on the economic assimilation outcomes of the descendants of immigrants who mainly arrived in the Netherlands in the post-World War II period. Acknowledging a high degree of diversity in the starting positions of immigrants associated with their dominant migration motives, we estimate the Dutch-migrant group gap in incomes from an intergenerational mobility perspective. Our descriptive rank-rank analysis reveals significant ethnic disparities in absolute and relative intergenerational income mobility. The absolute mobility of the ethnic groups we study appears to have the following rank order: Moroccan, Turkish Surinamese, Indish, German, and Dutch. While a higher level of intergenerational transmission of parental income narrows the gap for Turkish and Surinamese children, it widens the gap for Indish and Moroccan children. Our decomposition analysis shows that the ethnic disparities found for the Moroccan, Turkish, and Surinamese third generation are entirely explained by their relatively young ages and associated unfavorable socioeconomic positions, and by their lower parental income levels.

Ethnic background and children\u2019s oral health-related quality of life

PurposeEthnic background is known to be related to oral health and socioeconomic position (SEP). In the context of patient-centered oral health care, and the growing number of migrant children, it is important to understand the influence of ethnic background on oral health-related quality of life (OHRQoL). Therefore, we aimed to identify the differences in children’s OHRQoL between ethnic groups, and the contribution of oral health status, SEP, and immigration characteristics.MethodsThis study was part of the Generation R Study, a prospective cohort study conducted in Rotterdam, the Netherlands. In total, 3121 9-year-old children with a native Dutch (n = 2510), Indonesian (n = 143), Moroccan (n = 104), Surinamese (n = 195), or Turkish (n = 169) background participated in the present study. These ethnicities comprise the most common ethnic groups in the Netherlands. OHRQoL was assessed using a validated short form of the child oral health impact profile. Several regression models were used to study an association between ethnic background and OHRQoL, and to identify potential mediating factors.ResultsTurkish and Surinamese ethnic background were significantly associated with lower OHRQoL. After adjusting for mediating factors, only Surinamese children had a significantly lower OHRQoL than Dutch children (β:− 0.61; 95% CI− 1.18 to –0.04).ConclusionsOur results show that Turkish and Surinamese children have a significantly lower OHRQoL than native Dutch children. The association was partly explained by oral health status and SEP, and future studies are needed to understand (cultural) the determinants of ethnic disparities in OHRQoL, in order to develop effective oral health programs targeting children of different ethnic groups.

Ethnicity and socioeconomic status are related to dietary patterns at age 5 in the Amsterdam born children and their development (ABCD) cohort

BackgroundHealth inequalities are already present at young age and tend to vary with ethnicity and socioeconomic status (SES). Diet is a major determinant of overweight, and studying dietary patterns as a whole in relation to overweight rather than single nutrients or foods has been suggested. We derived dietary patterns at age 5 and determined whether ethnicity and SES were both related to these dietary patterns.MethodsWe analysed 2769 validated Food Frequency Questionnaires filled in by mothers of children (5.7 ± 0.5y) in the Amsterdam Born Children and their Development (ABCD) cohort. Food items were reduced to 41 food groups. Energy adjusted intake per food group (g/d) was used to derive dietary patterns using Principal Component Analysis and children were given a pattern score for each dietary pattern. We defined 5 ethnic groups (Dutch, Surinamese, Turkish, Moroccan, other ethnicities) and 3 SES groups (low, middle, high, based on maternal education). Multivariate ANOVA, with adjustment for age, gender and maternal age, was used to test potential associations between ethnicity or SES and dietary pattern scores. Post-hoc analyses with Bonferroni adjustment were used to examine differences between groups.ResultsPrincipal Component Analysis identified 4 dietary patterns: a snacking, full-fat, meat and healthy dietary pattern, explaining 21% of the variation in dietary intake. Ethnicity was related to the dietary pattern scores (p < 0.01): non-Dutch children scored high on snacking and healthy pattern, whereas Turkish children scored high on full-fat and Surinamese children on the meat pattern. SES was related to the snacking, full-fat and meat patterns (p < 0.01): low SES children scored high on the snacking and meat pattern and low on the full-fat pattern.ConclusionsThis study indicates that both ethnicity and SES are relevant for dietary patterns at age 5 and may enable more specific nutrition education to specific ethnic and low socioeconomic status target groups.

A national study on the prevalence of child abuse and neglect in Suriname

The prevalence of child maltreatment in Suriname has never been subjected to a reliable assessment. The only data available include rough estimates of a range of internationally comparable indicators extrapolated from child protection and police corps statistics for offenses against children. This study aimed to provide a reliable estimate of the prevalence of all forms of child maltreatment in Suriname. One thousand three hundred and ninety-one (1,391) adolescents and young adults of different ethnicities completed a questionnaire about child maltreatment. The study sample, obtained by random probability sampling, consisted of students (ages 12 through 22) from five districts in Suriname. A significant proportion of Surinamese children experienced maltreatment. In total, 86.8% of adolescents and 95.8% of young adults reported having been exposed to at least one form of child maltreatment during their lives. Among the adolescents, 57.1% were exposed to child maltreatment in the past year. When the definition of the National Incidence Study was applied, 58.2% of adolescents and 68.8% of young adults had been exposed to at least one form of maltreatment. Among adolescents, 36.8% reported having experienced at least one form of maltreatment in the past year. The results indicate the (extremely) high lifetime and year prevalence of child maltreatment in Suriname. The serious and often lifelong consequences of such maltreatment indicate that a national approach to child abuse and neglect, including the development of a national strategic plan, a national surveillance system and changes to the state's programmatic and policy response, is urgently needed.

Ethnic Background and Overweight among 5-Year-Old Children: The “Be Active, Eat Right” Study

Introduction. This study investigates the association between ethnic background and overweight (obesity included) among 5 year olds. Methods. We used baseline data from 5 year olds (n = 7801) and their parents collected for the “Be active, eat right” study. A child was considered to be of non-Dutch ethnic background when at least one of the parents was born abroad. Odds ratios (ORs) were adjusted for sociodemographic characteristics. Results. Compared to children of Dutch ethnic background, for children with a Moroccan ethnic background the OR for being overweight (obesity included) was 2.27 (95% CI 1.48–3.47), for Turkish children the OR was 3.63 (95% confidence interval (CI) 2.46–5.35), for Antillean children the OR was 1.97 (95% CI 1.01–3.86), and for Surinamese children the OR was 0.47 (95% CI 0.20–1.06). Addition of parental overweight decreased the ORs for Moroccan and Turkish children by 10.2% and 12.5%, and addition of watching TV and having breakfast by the child decreased the ORs by 7.9% and 12.2%. Conclusion. Already at a young age, children of Moroccan and Turkish ethnic background are at increased risk for being overweight compared to Dutch children. Parental overweight, watching TV, and not having breakfast by the child are contributing factors in this association.

Ethnic Background and Television Viewing Time Among 4-Year-Old Preschool Children

Children's television viewing has been associated with an increased risk of overweight and obesity. This study aims to assess the associations of ethnic background and acculturation characteristics with television viewing time in 4-year-old preschool children. The authors analyzed data from 3452 preschool children and their parents enrolled in the Generation R Study, a large, multiethnic, prospective birth cohort study in Rotterdam, the Netherlands. Multivariable logistic regression models were used to estimate odds ratios of watching television ≥2 hours/day and ≥1 hour/day for Turkish, Moroccan, and Surinamese children (reference group: native Dutch children), adjusted for family socioeconomic position. Effect modification by family socioeconomic position was also assessed. After adjustment for family socioeconomic position, Turkish children (adjusted odds ratio [aOR], 2.27; 95% confidence interval [CI], 1.56-3.30), Moroccan children (aOR, 1.68; 95% CI, 1.03-2.76), and Surinamese children (aOR, 3.12; 95% CI, 2.16-4.50) were significantly more likely to watch television ≥2 hours/day compared with native Dutch children. Stratified analyses showed greater disparity between ethnic minority groups and native Dutch children at higher educational levels. There were no significant associations between acculturation characteristics (i.e., generational status, age at immigration, and Dutch language skills) and children's television viewing time. Children from ethnic minority groups are at an increased risk for high levels of television viewing compared with native Dutch children, independent of family socioeconomic position. Interventions aimed to reduce television viewing time should target all children from ethnic minority groups.

Fasting Predisposes to Hypoglycemia in Surinamese Children with Severe Pneumonia, and Young Children are More at Risk

The objective of this study was to investigate glucose kinetics during controlled fasting in children with severe pneumonia. Plasma glucose concentration, endogenous glucose production and gluconeogenesis were measured in 12 Surinamese children (six young: 1-3 years, six older: 3-5 years) with severe pneumonia during a controlled 16 h fast using stable isotopes [6,6-(2)H2]glucose and (2)H2O at a hospital-based research facility. On admission, the glucose concentrations were comparable in both groups: young children: 5.1 ± 1.3 mmol/l, older children: 4.8 ± 0.6 mmol/l, p = 0.685, with a decrease during the first 8 h of fasting in the young children only to 3.6 ± 0.5, p = 0.04. Glucose production was comparable in both groups: young: 24.5 ± 8.3, older: 24.9 ± 5.9 µmol/kg(•)min, p = 0.926. Between 8 and 16 h of fasting, the glucose concentration decreased comparably in both groups (young: - 0.9 ± 0.7, p = 0.004; older: -1.0 ± 0.4 mmol/l, p = 0.001), as did glucose production (young: -6.8 ± 6.3, p = 0.003; older: -5.3 ± 3.4 µmol/kg(•)min, p = 0.001). Gluconeogenesis decreased in young children only: -5.0 ± 7.4, p = 0.029. We conclude that fasting predisposes to hypoglycemia in children with severe pneumonia. Young children are more at risk than older children. Glucose production is an important determinant of the plasma glucose concentration in young children with pneumonia, indicating an inability to reduce glucose usage. Our results are largely in agreement with the literature on the adaptation of glucose metabolism in children with malaria, although there seem to be disease-specific differences in the regulation of gluconeogenesis.

Fatal intoxication due to ackee ( Blighia sapida) in Suriname and French Guyana. GC–MS detection and quantification of hypoglycin-A

Between 1998 and 2001 the deaths of 16 Surinamese children were recorded along the Maroni River, which forms the border between Suriname and French Guyana. After a metabolic origin was eliminated, ethnobotanical research in the field led to a hypothesis of intoxication through the ingestion of ackee. Ackee ( Blighia sapida) is a large green leafy tree of West African origin. Its unripe fruit contains large quantities of two toxic molecules: hypoglycin-A and hypoglycin-B, the former being the more toxic. We have developed a GC–MS procedure allowing us to demonstrate the presence of hypoglycin-A in the gastric fluid of one of the deceased children, and to compare the content of hypoglycin-A in fruit collected on the road to Paramaribo in Suriname (5.1 mg/g) with samples from Burkina Faso (8.1 mg/g) and Jamaica (9.2 mg/g). Field research showed the misuse of this little-known plant by Maroon witch doctors. The Bushinengue witch doctors were informed about the dangers of ackee, and no new cases have been reported to date.

Glucose Kinetics during Fasting in Young Children with Severe and Non-severe Malaria in Suriname

Fasting could be an important factor in the induction of hypoglycemia in children with malaria because fasting results in a decrease in endogenous glucose production. The influence of extended fasting on plasma glucose concentration, glucose production, and gluconeogenesis were measured using [6,6-(2)H(2)]glucose and (2)H(2)O in 12 Surinamese children with severe malaria and compared with 16 children with non-severe malaria during a 16-hour controlled fast. Glucose concentration and glucose production were comparable after 8 hours of fasting and decreased in both groups (P < 0.001) with an extension of the fast up to 16 hours. Glucose concentration decreased faster in the non-severe group than in the severe group (P = 0.029). The decrease in glucose production was not different between groups (P = 0.954). Thus, fasting predisposes for hypoglycemia in young children with Plasmodium falciparum malaria. Hypoglycemia caused by fasting develops later in young children with severe malaria than in children with non-severe malaria.

Very young children with uncomplicated falciparum malaria have higher risk of hypoglycaemia: a study from Suriname

To measure glucose kinetics and the influence of age, nutritional status and fasting duration in children with uncomplicated falciparum malaria (UFM) under the age of 5 years. Plasma glucose concentration, endogenous glucose production (EGP) and gluconeogenesis (GNG) were measured using [6,6-(2)H(2)]glucose and (2)H(2)O in 17 very young (<3 years) and 7 older (3-5 years) Surinamese children with UFM admitted to the Distrikt Hospital Stoelmanseiland and Diakonessen Hospital Paramaribo over 17 months. Plasma glucose concentration was lower in the group of very young children than in the older children (P = 0.028). There were no differences in EGP and GNG between the groups. Overall GNG contributed 56% (median, range 17-87%) to EGP, with no differences between the groups (P = 0.240). Glucose clearance was lower in the older children (P = 0.026). Glucose concentration did not differ between children with weight for length/height less than -1.3 SD and children with weight for length/height greater than -1.3 SD (P = 0.266). Plasma glucose concentration was not predicted by fasting duration (P = 0.762). Our data suggest a higher risk of hypoglycaemia in very young children with uncomplicated malaria as plasma glucose concentration was lower in this study group. Since this could not be attributed to an impaired EGP, and because glucose clearance was lower in the older children, we presume that older children were better capable of reducing glucose utilization during fasting. Studies on glucose kinetics are feasible in very young children with malaria and give more insight in the pathophysiology of hypoglycaemia.

Predictors of asthma control in children from different ethnic origins living in Amsterdam

To identify factors associated with asthma control in a multi-ethnic paediatric population. We interviewed 278 children with paediatrician diagnosed asthma (aged 7-17 years) and one of their parents. Asthma control was assessed with the Asthma Control Questionnaire (ACQ). Detailed information about sociodemographic variables, asthma medication, knowledge of asthma, inhalation technique and environmental factors were collected. Turkish and Moroccan parents were interviewed in their language of choice. Logistic regression analyses were used to identify correlates of asthma control. Of the 278 children, 85 (30.6%) were Dutch, 84 (30.2%) were Moroccan, 58 (20.9%) were Turkish and 51 (18.3%) were Surinamese. Overall, almost 60% had a status of well-controlled asthma, as indicated by the ACQ. Only 51 of the 142 (35.9%) Moroccan and Turkish parents had a good comprehension of the Dutch language. In logistic regression analyses the risk of having uncontrolled asthma was significantly higher among Surinamese children (OR 2.3; 95% CI 1.06-4.83), respondents with insufficient comprehension of the Dutch language (OR 2.3; 95% CI 1.08-4.78), children using woollen blankets (OR 9.8; 95% CI 1.52-63.42), and significantly lower among male (OR 0.5; 95% CI 0.31-0.91) and non-daily users of inhaled corticosteroids (OR 0.6; 95% CI 0.38-1.07). In conclusion, ethnicity as well as insufficient comprehension of the Dutch language appeared to be independent risk factors for uncontrolled asthma. Special attention should be given to children from immigrants groups for example by calling in an interpreter by physicians when comprehension is insufficient.

Different Treatment Thresholds in Non-Western Children With Behavioral Problems

First, to investigate whether non-Western children in the Netherlands are less likely to be treated for behavioral problems than Western children; second, to examine whether discrepancies in treatment status are related to differences in level of problem behavior and impairment. The study included 2,185 children of the four largest ethnic groups in the Netherlands, namely, 684 Dutch, 702 Moroccan, 434 Turkish, and 365 Surinamese children from grades three to five of elementary school. Teachers completed the Strengths and Difficulties Questionnaire and five DSM-IV items on externalizing problems. In addition, they provided information on the treatment status of the child. Moroccan boys displayed more problem behavior, Turkish boys less problem behavior, and Surinamese boys similar rates of problem behavior compared with Dutch boys. No difference in problem behavior was found between Western and non-Western girls. Adjusted for age, level of problem behavior, and impairment, Moroccan and Turkish children and Surinamese girls were less likely to receive treatment for problem behavior. The higher treatment thresholds of non-Western children compared with Western children in the Netherlands could not be explained by differences in level of problem behavior or impairment. Detection of behavioral problems in non-Western children should receive more attention.

Racist victimization among children in The Netherlands: the effect of ethnic group and school

Using data from a nation-wide study, this article examines the extent of racist victimization among Dutch, Turkish, Moroccan and Surinamese children (10-13 years) in The Netherlands. The responses indicate that ethnic minority children are more often victim of racist name-calling and social exclusion than are Dutch children. Furthermore, Turkish children are more likely to face racism than Surinamese and Moroccan children. Using multilevel analysis, the effects of multicultural education and the ethnic composition of the school were also examined. If teachers reacted to incidents, this had a positive effect on racism. Furthermore, multicultural education was positively related to reported experiences with racist victimization, but this effect was only found for the Dutch children. In addition, a higher percentage of Dutch pupils was related to less racist victimization of the Dutch and to more victimization of the three ethnic minority groups.

An Interview With Thea Doelwijt

An Interview with Thea Doelwijt Charles H. Rowell This interview took place in Amsterdam on April 11, 1988. ROWELL When you say that you write about matters of Suriname as opposed to writing immigrant theater, would you be more specific and tell us what you mean by immigrant theater as opposed to writing about Suriname? DOELWIJT The first things immigrants in Holland write about is their new situation, dealing with how to survive in this country and the things they meet, trying to live here, wanting to live here. They have to live here, they want to live here, they have chosen to live here and then they meet another society and they try to survive in it, try to feel their way in it. They meet a lot of problems and they try to write, to make plays about their new situation. I try to show Holland what it is for Surinamese people, who have left their country. I did two plays in Holland and one was for children, a special children’s play; that was the last play I could do in Suriname. And I tried to do it again in Holland, because I thought it very important for the children of immigrants, especially the Surinamese children, to look at a story of another country without too many problems. And I liked the fairy tale thing, also very much inspired by Suriname. Then I had to do it with young people—I wanted to do it with young people—about eighteen, twenty, twenty-five, but we’ve been living here for a long time—some were born here, some came when they were very small—and when I tried to do the Surinamese play, they couldn’t understand everything I wanted them to do. They did not have the feeling, the smell, the right movements; they didn’t know how to walk in the bush, they couldn’t imagine how, they didn’t know how to walk; it was very difficult for them to do that in the improvisations we did. So I had to rewrite the story. I had to start in Holland; otherwise I couldn’t even make it possible for the actors, who had lived too long in Holland. That was the children’s play, Roy Mi Boy. The other was a play called A Fat Black Woman Like Me and was based on one act plays by a Suriname doctor, a woman doctor, Sophie Redmond. She is quite well known and famous in Suriname as a doctor in the 1940s and 1950s, who also wrote plays, giving information and inspiration—some kind of folk theater—and teaching her people things about the circumstances in Suriname. One of the plays was about how to vote. This was the first time when elections started in Suriname. So the Surinamese people liked that I put in one program the plays of the Surinamese doctor, Sophie Redmond, and I also made a link to the situation today. We did the play in Dutch, and we did it in English too, one time, and sometimes we used the Surinamese language, and then always followed by a translation in Dutch. And that was why the Dutch people also liked the program. It was very gay, a lot of laughing and hilarity, and all kinds of very typical Surinamese ways of how women are dealing with their men. I try to bring the plays and stories of Suriname to the people of Suriname here and also to the Dutch people, to let them all feel that there are also very good and happy people, people just like you and me and not only those in a difficult situation, an immigrant’s situation, with a lot of problems. And [End Page 611] I don’t say that all immigrants who are writing here always talk about problems, but that is one of the things that, of course, you tell about if you are an immigrant. My last play was Iris, a monologue by a Surinamese actress, Orsyla Meinzak, who died just last year, for whom I wrote a monologue about getting old in Holland, about leaving Suriname because of the political situation...

Risk indicators and potential risk factors for caries in 5-year-olds of different ethnic groups in Amsterdam.

The aim of this study was threefold: first, to assess the oral health of Turkish, Moroccan, Surinamese, Dutch and "other" 5-yr-old children living in Amsterdam; second, to identify risk indicators for caries, in addition to ethnicity; and third, to identify potential risk factors related to differences in caries experience in these children. Results showed the mean dmfs scores of Turkish and Moroccan children to be much higher than that of the Dutch and Surinamese children; 8.1 and 8.2 versus 3.6 and 3.4, respectively. The educational level of the parents and the gender of the children were important risk indicators, in addition to ethnicity. The age of the child at which the parents had started to brush their child's teeth, the use of fluoride tablets and the regularity of the brushing behavior in the past could be identified as potential risk factors.

Bilingualism and cognitive‐linguistic development: Evidence from a word association task and a sorting task

Abstract This article reports the results of a study on the influence of bilingualism on the level of cognitive‐linguistic development of ethnic minority children. Subjects were monolingual Dutch children, and bilingual Turkish, Moroccan and Surinamese children living in The Netherlands. A word association task and a sorting task were administered. Both tasks were analysed with respect to the semantic‐episodic distinction on the assumption that relatively more semantic responses in the association task and more semantic classifications in the sorting task point to a higher level of cognitive‐linguistic development. The association task was also analysed for the relative numbers of paradigmatic and syntagmatic responses, the former also indicating a higher level of development. The main finding is that there were no differences between the four groups on the variables studied. Therefore, it was concluded that bilingualism did not affect cognitive‐linguistic development negatively.